The disease varies during pregnancy and may improve, worsen, or remain stable. In the first pregnancy, the disease is more likely to worsen during the first 3 months, while in the second pregnancy, it is more likely to worsen during the last 3 months and after delivery. Nevertheless, myasthenia gravis is not a contraindication to pregnancy. Spontaneous abortion due to myasthenia gravis is uncommon. Cholinesterase inhibitors and prednisone are safe for the fetus and there is no evidence of adverse effects on the infant in pregnant women taking high doses of prednisone. Azathioprine and cyclophosphamide, on the other hand, may have teratogenic effects and should always be discontinued before pregnancy. Although there are no large clinical trials to confirm whether propecia or plasma exchange has an effect on pregnant women, the current data suggest that it is safe. Paroxysmal pain and labor are usually normal in affected women, and cesarean section is used only for those with obstetric indications. Local anesthesia is preferred for delivery or cesarean section, and magnesium sulfate is used with caution in the management of preeclampsia; barbiturates are available. Although there is a theoretical risk of maternal transmission of disease-causing antibodies to the infant through breast milk, breastfeeding is not restricted in clinical practice. In the clinic, we often meet women with myasthenia gravis who ask what to do in case of pregnancy and delivery. Patients and their families assume that since they have myasthenia gravis, they will not have the strength to deliver the baby and want to have a cesarean section. Is this really the case? In fact, the uterus is composed of smooth muscle and is not affected by antibodies to acetylcholine receptors, so vaginal delivery is still recommended for pregnant women with myasthenia gravis. However, it is important to note that during the second stage of labor, many skeletal muscle contractions (including abdominal muscles, diaphragm and pelvic floor muscles) are involved, and it is necessary to induce labor with forceps or cephalic suction because the skeletal muscles are affected by the acetylcholine receptor antibodies and produce weakness. Since the procedure itself is a stressful one for myasthenia gravis, cesarean delivery is usually considered only when the pregnant woman presents with obstetric indications. It is also worth mentioning that epidural anesthesia can be used during labor and delivery without much concern for the patient.